Acute hepatitis B outbreak in a nursing home for the disabled in Türkiye.

Background: Although hepatitis B is vaccine-preventable, it remains a significant health problem. To the best of our knowledge, this is the first hepatitis B outbreak report from Türkiye. Aims: To investigate the cause of hepatitis B outbreak in a nursing home for the disabled and make recommendations for prevention. Methods: An outbreak of acute hepatitis B was declared in a nursing home for the disabled following the admission of 3 patients from the home in a hospital. Collaborative response was initiated with the Provincial Health Directorate through the Public Health Infectious Diseases Department. We began tracking the infection and monitoring active cases. Audits and controls were carried out to determine the source, establish protection and control measures, and prevent further transmission. Results: Six of the 65 nursing home residents were diagnosed with acute hepatitis B. Four of them had diabetes and their blood glucose levels were monitored for at least 12 months. Two of the patients had received dental treatment in the last 6 months. The frequency of both variables, which may be an indication of the transmission route, was statistically significantly greater in the acute hepatitis B group. All the patients who could be sequenced were identified as genotype D. While 3 patients recovered fully, 2 were diagnosed with chronic hepatitis B and one died due to fulminant hepatitis. Conclusion: Standard routine immunization should be implemented as a preventive measure for acute hepatitis B. Frequent supervision and training on hygiene practices and safety precautions should be conducted for care staff working in collective residential facilities.

Treatment initiation rates of patients with positive anti-hepatitis C virus results in tertiary hospitals in Turkey.

INTRODUCTION: The aim of this national, multicenter, cross-sectional, retrospective chart review study was to determine the proportion of patients in Turkey who received hepatitis C virus (HCV) treatment after receiving positive anti-HCV results during HCV screening. METHODOLOGY: Data related to patients' demographics, laboratory results, time interval from obtaining a positive anti-HCV result to treatment initiation, specialty of the physician requesting anti-HCV screening, and type of hospital were analyzed. RESULTS: Among 1,000 patients who received a positive anti-HCV result, 50.3% were male and 78.5% were screened for HCV-RNA. Among HCV-RNA screened patients, 54.8% (n = 430) had a positive result. Among patients who tested positive for HCV-RNA, 72.8% received HCV treatment in line with their positive anti-HCV results. The median time from obtaining a positive anti-HCV result to initiation of HCV treatment was 91.0 days (interquartile range 42.0 to 178.5). Non-surgical branches requested HCV-RNA testing more frequently than surgical branches (p < 0.001). The rate of access to HCV treatment was higher among patients screened in university hospitals than among patients screened in training and research hospitals (p < 0.001). CONCLUSIONS: Our results indicate a higher rate of treatment initiation among patients with HCV infection than is described in the published literature. Furthermore, the time from screening to treatment initiation was considerably shorter compared with other international studies. However, since HCV-RNA testing was not requested in a significant portion of patients with a positive anti-HCV test result, there might be a large patient population with HCV who do not receive treatment.